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3.
Front Immunol ; 12: 735125, 2021.
Article in English | MEDLINE | ID: covidwho-1441109

ABSTRACT

Background: The global outbreak of coronavirus disease 2019 (COVID-19) has turned into a worldwide public health crisis and caused more than 100,000,000 severe cases. Progressive lymphopenia, especially in T cells, was a prominent clinical feature of severe COVID-19. Activated HLA-DR+CD38+ CD8+ T cells were enriched over a prolonged period from the lymphopenia patients who died from Ebola and influenza infection and in severe patients infected with SARS-CoV-2. However, the CD38+HLA-DR+ CD8+ T population was reported to play contradictory roles in SARS-CoV-2 infection. Methods: A total of 42 COVID-19 patients, including 32 mild or moderate and 10 severe or critical cases, who received care at Beijing Ditan Hospital were recruited into this retrospective study. Blood samples were first collected within 3 days of the hospital admission and once every 3-7 days during hospitalization. The longitudinal flow cytometric data were examined during hospitalization. Moreover, we evaluated serum levels of 45 cytokines/chemokines/growth factors and 14 soluble checkpoints using Luminex multiplex assay longitudinally. Results: We revealed that the HLA-DR+CD38+ CD8+ T population was heterogeneous, and could be divided into two subsets with distinct characteristics: HLA-DR+CD38dim and HLA-DR+CD38hi. We observed a persistent accumulation of HLA-DR+CD38hi CD8+ T cells in severe COVID-19 patients. These HLA-DR+CD38hi CD8+ T cells were in a state of overactivation and consequent dysregulation manifested by expression of multiple inhibitory and stimulatory checkpoints, higher apoptotic sensitivity, impaired killing potential, and more exhausted transcriptional regulation compared to HLA-DR+CD38dim CD8+ T cells. Moreover, the clinical and laboratory data supported that only HLA-DR+CD38hi CD8+ T cells were associated with systemic inflammation, tissue injury, and immune disorders of severe COVID-19 patients. Conclusions: Our findings indicated that HLA-DR+CD38hi CD8+ T cells were correlated with disease severity of COVID-19 rather than HLA-DR+CD38dim population.


Subject(s)
CD8-Positive T-Lymphocytes/immunology , COVID-19/immunology , Immune System Diseases/immunology , SARS-CoV-2 , Adult , Aged , CD8 Antigens/immunology , Cytokines/immunology , Female , HLA-DR Antigens/immunology , Humans , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Young Adult
4.
Vaccines (Basel) ; 9(9)2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1390818

ABSTRACT

Background: The SARS-CoV-2 vaccine has been widely rolled out globally in the general populations. However, specific data on vaccination confidence, willingness or coverage among health care workers (HCWs) has been less reported. Methods: A cross-sectional online survey was conducted to specify the basic data and patterns of vaccination confidence, willingness and coverage among HCWs nationwide. Results: In total, 2386 out of 2583 (92.4%) participants were enrolled for analysis, and the rates of confidence in vaccine, professional institutes and government were 75.1%, 85.2% and 85.4%, respectively. The overall vaccination coverage rate was 63.6% which was adjusted as 82.8% for participants under current medical conditions or having contraindications. Confidence in vaccine safety was shown to be the most related factor to willingness among doctors, nurses, medical technicians and hospital administrators, while confidence in vaccine effectiveness as well as trust in government played the key role in formulating public health employees' willingness. 130 (7.1% of 1833) participants reporting willingness still not been vaccinated regardless of contraindications. Multivariate analysis among willingness participants showed that males, aged over 30 years, public health employees and higher vaccination confidence had significantly higher vaccination rates with ORs (95% confidence intervals) as 1.64 (1.08-2.49), 3.14 (2.14-4.62), 2.43 (1.46-4.04) or 2.31 (1.24-4.33). Conclusions: HCWs' confidence, willingness and coverage rates to the vaccine were generally at high levels. Heterogeneity among HCWs should be considered for future vaccination promotion strategies. The population's confidence in vaccination is not only the determinant to their willingness, but also guarantees their actual vaccine uptake.

5.
J Womens Health (Larchmt) ; 30(11): 1546-1555, 2021 11.
Article in English | MEDLINE | ID: covidwho-1376276

ABSTRACT

Objective: The outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) threatens a surging number of community groups within society, including women actively breastfeeding. Breastfeeding involves intimate behaviors, a major transmission route of SARS-CoV-2, and is integral to the close mother-baby relationship highly correlated with maternal psychological status. Materials and Methods: Twenty-three pregnant women and puerperae with either confirmed or suspected diagnoses of COVID-19 were enrolled in the study. The clinical characteristics and outcomes of the mothers and neonates were recorded. The presence of SARS-CoV-2, IgG, and IgM in breast milk, maternal blood, and infant blood, together with feeding patterns, was assessed within 1 month after delivery. Feeding patterns and maternal psychological status were also recorded in the second follow-up. Results: No positive detection of SARS-CoV-2 was found in neonates. All breast milk samples were negative for the detection of SARS-CoV-2. The presence of IgM for SARS-CoV-2 in breast milk was correlated with IgM presence in the maternal blood. The results of IgG detection for SARS-CoV-2 were negative in all breast milk samples. All infants were in a healthy condition in two follow-ups, and antibody tests for SARS-CoV-2 were negative. The rate of breast milk feeding increased during two follow-ups. All mothers receiving a second follow-up experienced negative psychological factors and status. Conclusions: Our findings support the feasibility of breastfeeding in women infected with SARS-CoV-2. The additional negative psychological status of mothers due to COVID-19 should also be considered during the puerperium period.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Breast Feeding , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Infectious Disease Transmission, Vertical , Laboratories , Mothers , Pandemics , Pregnancy , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2
6.
J Microbiol Immunol Infect ; 2021 Aug 25.
Article in English | MEDLINE | ID: covidwho-1370605

ABSTRACT

BACKGROUND: To explore the development of central nervous system (CNS) symptoms and clinical application in predicting the clinical outcomes of SARS-COV-2 patients. METHODS: A retrospective cohort study was performed on the hospitalized patients with SARS-COV-2 recruited from four hospitals in Hubei Province, China from 18 January to 10 March 2020. The patients with CNS symptoms were determined. Data regarding clinical symptoms and laboratory tests were collected from medical records. RESULTS: Of 1268 patients studied, 162 (12.8%) had CNS symptoms, manifested as unconsciousness (71, 5.6%), coma (69, 5.4%), dysphoria (50, 3.9%), somnolence (34, 2.7%) and convulsion (3, 0.2%), which were observed at median of 14 (interquartile range 9-18) days after symptom onset and significantly associated with older age (OR = 5.71, 95% confidence interval [CI] 2.78-11.73), male (OR = 1.73, 95% CI 1.22-2.47) and preexisting hypertension (OR = 1.78, 95% CI 1.23-2.57). The presence of CNS symptoms could be predicted by abnormal laboratory tests across various clinical stages, including by lymphocyte counts of <0.93 × 109/L, LDH≥435 U/L and IL-6≥28.83 pg/L at 0-10 days post disease; by lymphocyte count<0.86 × 109/L, IL-2R ≥ 949 U/L, LDH≥382 U/L and WBC≥8.06 × 109/L at 11-20 days post disease. More patients with CNS symptoms developed fatal outcome compared with patients without CNS symptoms (HR = 33.96, 95% CI 20.87-55.16). CONCLUSION: Neurological symptoms of COVID-19 were related to increased odds of developing poor prognosis and even fatal infection.

7.
PeerJ ; 9: e11397, 2021.
Article in English | MEDLINE | ID: covidwho-1359402

ABSTRACT

Background: Air pollution leads to many adverse health conditions, mainly manifested by respiratory or cardiac symptoms. Previous studies are limited as to whether air pollutants were associated to influenza-like illness (ILI). This study aimed to explore the association between air pollutants and outpatient visits for ILI, especially during an outbreak of influenza. Methods: Daily counts of hospital visits for ILI were obtained from Peking University Third Hospital between January 1, 2015, and March 31, 2018. A generalized additive Poisson model was applied to examine the associations between air pollutants concentrations and daily outpatient visits for ILI when adjusted for the meteorological parameters. Results: There were 35862 outpatient visits at the fever clinic for ILI cases. Air quality index (AQI), PM2.5, PM10, CO and O3 on lag0 days, as well as nitrogen dioxide (NO2) and sulfur dioxide (SO2) on lag1 days, were significantly associated with an increased risk of outpatient visits for ILI from January 2015 to November 2017. From December 2017 to March 2018, on lag0 days, air pollutants PM2.5 [risk ratio (RR) = 0.971, 95% CI: 0.963-0.979], SO2 (RR = 0.892, 95% CI: 0.840-0.948) and CO (RR = 0.306, 95% CI: 0.153-0.612) were significantly associated with a decreased risk of outpatient visits for ILI. Interestingly, on the lag2 days, all the pollutants were significantly associated with a reduced risk of outpatient visits for ILI except for O3. We did not observe the linear correlations between the outpatient visits for ILI and any of air pollutants, which were instead associated via a curvilinear relationship. Conclusions: We found that the air pollutants may be associated with an increased risk of outpatient visits for ILI during the non-outbreak period and with a decreased risk during the outbreak period, which may be linked with the use of disposable face masks and the change of outdoor activities. These findings expand the current knowledge of ILI outpatient visits correlated with air pollutants during an influenza pandemic.

8.
PLoS One ; 16(8): e0249872, 2021.
Article in English | MEDLINE | ID: covidwho-1341484

ABSTRACT

This paper analyzes the application of various telemedicine services in Gansu Province, China during the COVID-19 epidemic, and summarizes the experiences with these services. In addition, the satisfaction levels of patients and doctors with the application of telemedicine in COVID-19 were investigated, the deficiencies of telemedicine in Gansu were determined, and recommendations for modification were proposed. Coronavirus Disease 2019 (COVID-19) has broken out in China, and Gansu Province in Northwest of China has not been spared. To date, there are 91 local COVID-19 cases and 42 imported cases. 109 hospitals were selected as designated hospitals during the COVID-19 outbreak, and most of them were secondary hospitals. However, it was unsatisfactory that the ability of medical services is relatively low in most of secondary hospitals and primary hospitals. Therefore, we helped the secondary hospitals cope with COVID-19 by means of remote consultation, long-distance education, telemedicine question and answer (Q&A). Our practical experience shows that telemedicine can be widely used during the COVID-19 epidemic, especially in developing countries and areas with lagging medical standards.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Telemedicine/organization & administration , China/epidemiology , Disease Outbreaks , Education, Distance/organization & administration , Education, Distance/statistics & numerical data , Education, Medical, Continuing/methods , Education, Medical, Continuing/organization & administration , Education, Medical, Continuing/statistics & numerical data , Education, Nursing, Continuing/methods , Education, Nursing, Continuing/organization & administration , Education, Nursing, Continuing/statistics & numerical data , Epidemics , Geography , Health Services Accessibility/organization & administration , Health Services Accessibility/statistics & numerical data , Humans , Physician-Patient Relations , Remote Consultation/instrumentation , Remote Consultation/methods , Remote Consultation/organization & administration , Remote Consultation/statistics & numerical data , SARS-CoV-2/physiology , Software , Telemedicine/instrumentation , Telemedicine/methods
9.
Math Biosci Eng ; 18(3): 2775-2788, 2021 03 24.
Article in English | MEDLINE | ID: covidwho-1289075

ABSTRACT

OBJECTIVE: To identify the internal mechanism of the relationship between physical activity and mental health in home exercises. METHODS: Participants were 2233 college students with an average age of 19.34 (SD = 1.07) recruited from southern China using analysis of variance (ANOVA) and hierarchical multiple regression. They completed the college student physical activity questionnaire, regulatory emotional self-efficacy scale (RES) and Symptom Checklist (SCL-90) to explore the internal mechanism of the relationship between home exercises and mental health in the context of fitness campaign. RESULTS: Statistical analysis based on ANOVA and hierarchical multiple regression, and the results showed that gender differences is a critical factor influencing the effectiveness of home exercise on mental health in college students. Furthermore, individuals with regulatory emotional self-efficacy are more likely to keep exercising, which may stimulate the positive effect on enhancing mental health. CONCLUSION: Variable of emotion regulation efficacy play an important role in promoting college students positive emotions, stimulating potential, and improving physical and mental health. Further to advocate sports interventions for home-stay groups to improve their control of emotions, thereby reducing their anxiety and depression in the face of unexpected events.


Subject(s)
COVID-19 , Medical Informatics , Adult , China , Emotions , Humans , Mental Health , Self Efficacy , Surveys and Questionnaires , Young Adult
10.
Zhongguo Huanjing Kexue = China Environmental Science ; 41(5):2028, 2021.
Article in English | ProQuest Central | ID: covidwho-1257860

ABSTRACT

Based on hourly concentration of PM2.5 and O3 during the epidemic period(January 24, 2020 to May 31, 2020) in Changsha, Zhuzhou and Xiangtan, the diurnal patterns, long-term persistence, multifractality and self-organization evolution dynamics of these two pollutants were studied to reveal the internal dynamic mechanism of the occurrence and evolution of heavy pollution events during the epidemic period. Firstly, the diurnal patterns of PM2.5 and O3 concentrations were investigated. It showed that O3 showed a single peak of high concentration in the daytime and low in the night, while PM2.5 showed a single lowest peak concentration in the day and high in the night, which was different from the pattern in non-epidemic periods. Furthermore, detrended fluctuation analysis(DFA), the multifractal detrended fluctuation analysis(MFDFA) and probability statistical analysis were applied to study the long-term persistence, multi-fractal structure of PM2.5 and O3 series. The results showed that PM2.5 and O3 series had significant long-term persistence characteristics and strong multi-fractal structures for the three cities. Meanwhile, detrended cross-correlation analysis(DCCA) and multifractal detrended cross-correlation analysis(MFDCCA) were conducted to estimate the cross-correlations between PM2.5 and O3 series. Long-term persistence as well as multifractal features at different time scales was also observed in PM2.5-O3 cross-correlations. Next, nonlinear analysis results obtained during epidemic period were compared with those obtained in the same periods of non-epidemic years of 2019 and 2018. Finally, based on the self-organized criticality(SOC) theory, the internal dynamic law of spatial and temporal evolution of PM2.5 and O3 series was discussed. Combined with the typical regional meteorological characteristics, it was found that the intrinsic dynamic mechanism of SOC may be one of the leading mechanisms of heavy air pollution episodes during the COVID-19 lockdown period. During the epidemic period, PM2.5 and O3 concentrations did not evolve independently but remained complex interactions. Under the stable meteorological conditions, the nonlinear coupling effect inside the air combined pollution might reach the dynamic critical state, thus, lead to the risk of heavy air pollution in Greater Changsha Metropolitan Region during the epidemic period.

12.
Vaccine ; 39(21): 2833-2842, 2021 05 18.
Article in English | MEDLINE | ID: covidwho-1180090

ABSTRACT

BACKGROUND: Vaccination against coronavirus disease 2019 (COVID-19) has become an important public health solution. To date, there has been a lack of data on COVID-19 vaccination willingness, vaccine hesitancy, and vaccination coverage in China since the vaccine has become available. METHODS: We designed and implemented a cross-sectional, population-based online survey to evaluate the willingness, hesitancy, and coverage of the COVID-19 vaccine among the Chinese population. 8742 valid samples were recruited and classified as the vaccine-priority group (n = 3902; 44.6%) and the non-priority group (n = 4840; 55.4%). RESULTS: The proportion of people's trust in the vaccine, delivery system, and government were 69.0%, 78.0% and 81.3%, respectively. 67.1% of the participants were reportedly willing to accept the COVID-19 vaccination, while 9.0% refused it. 834 (35.5%) reported vaccine hesitancy, including acceptors with doubts (48.8%), refusers (39.4%), and delayers (11.8%). The current coverage was 34.4%, far from reaching the requirements of herd immunity. The predicted rate of COVID-19 vaccination was 64.9%, 68.9% and 81.1% based on the rates of vaccine hesitancy, willingness, and refusal, respectively. CONCLUSIONS: The COVID-19 vaccine rate is far from reaching the requirements of herd immunity, which will require more flexible and comprehensive efforts to improve the population's confidence and willingness to vaccinate. It should be highlighted that vaccination alone is insufficient to stop the pandemic; further efforts are needed not only to increase vaccination coverage but also to maintain non-specific prevention strategies.


Subject(s)
COVID-19 , Vaccines , COVID-19 Vaccines , China , Cross-Sectional Studies , Humans , SARS-CoV-2 , Vaccination
13.
Evol Med Public Health ; 2020(1): 264-278, 2020.
Article in English | MEDLINE | ID: covidwho-1104860

ABSTRACT

The COVID-19 pandemic has brought science into the public eye and to the attention of governments more than ever before. Much of this attention is on work in epidemiology, virology and public health, with most behavioural advice in public health focusing squarely on 'proximate' determinants of behaviour. While epidemiological models are powerful tools to predict the spread of disease when human behaviour is stable, most do not incorporate behavioural change. The evolutionary basis of our preferences and the cultural evolutionary dynamics of our beliefs drive behavioural change, so understanding these evolutionary processes can help inform individual and government decision-making in the face of a pandemic. Lay summary: The COVID-19 pandemic has brought behavioural sciences into the public eye: Without vaccinations, stopping the spread of the virus must rely on behaviour change by limiting contact between people. On the face of it, "stop seeing people" sounds simple. In practice, this is hard. Here we outline how an evolutionary perspective on behaviour change can provide additional insights. Evolutionary theory postulates that our psychology and behaviour did not evolve to maximize our health or that of others. Instead, individuals are expected to act to maximise their inclusive fitness (i.e, spreading our genes) - which can lead to a conflict between behaviours that are in the best interests for the individual, and behaviours that stop the spread of the virus. By examining the ultimate explanations of behaviour related to pandemic-management (such as behavioural compliance and social distancing), we conclude that "good of the group" arguments and "one size fits all" policies are unlikely to encourage behaviour change over the long-term. Sustained behaviour change to keep pandemics at bay is much more likely to emerge from environmental change, so governments and policy makers may need to facilitate significant social change - such as improving life experiences for disadvantaged groups.

14.
Euro Surveill ; 25(40)2020 10.
Article in English | MEDLINE | ID: covidwho-841040

ABSTRACT

BackgroundThe natural history of disease in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remained obscure during the early pandemic.AimOur objective was to estimate epidemiological parameters of coronavirus disease (COVID-19) and assess the relative infectivity of the incubation period.MethodsWe estimated the distributions of four epidemiological parameters of SARS-CoV-2 transmission using a large database of COVID-19 cases and potential transmission pairs of cases, and assessed their heterogeneity by demographics, epidemic phase and geographical region. We further calculated the time of peak infectivity and quantified the proportion of secondary infections during the incubation period.ResultsThe median incubation period was 7.2 (95% confidence interval (CI): 6.9‒7.5) days. The median serial and generation intervals were similar, 4.7 (95% CI: 4.2‒5.3) and 4.6 (95% CI: 4.2‒5.1) days, respectively. Paediatric cases < 18 years had a longer incubation period than adult age groups (p = 0.007). The median incubation period increased from 4.4 days before 25 January to 11.5 days after 31 January (p < 0.001), whereas the median serial (generation) interval contracted from 5.9 (4.8) days before 25 January to 3.4 (3.7) days after. The median time from symptom onset to discharge was also shortened from 18.3 before 22 January to 14.1 days after. Peak infectivity occurred 1 day before symptom onset on average, and the incubation period accounted for 70% of transmission.ConclusionThe high infectivity during the incubation period led to short generation and serial intervals, necessitating aggressive control measures such as early case finding and quarantine of close contacts.


Subject(s)
Coronavirus Infections/transmission , Coronavirus/pathogenicity , Infectious Disease Incubation Period , Pneumonia, Viral/transmission , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Child , Child, Preschool , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Epidemiologic Studies , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Young Adult
15.
Preprint | SSRN | ID: ppcovidwho-602

ABSTRACT

Background: Since December 2019, several dozens of ‘pneumonia of unknown origin’ cases, which now came to be known as COVID-19, appeared in Wuhan city, Hubepr

19.
Integr Med Res ; 9(3): 100489, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-671946

ABSTRACT

Background: The aim of this study was to evaluate the clinical efficacy of Xuanfei Baidu Decoction (XBD) combined with conventional drug therapy compared with conventional medicine alone in patients with coronavirus disease 2019 (COVID-19). Methods: Forty-two patients with COVID-19 were randomly assigned to XBD plus conventional medicine (n = 22) and conventional medicine alone (n = 20). Both groups were treated for 1 week. The primary endpoint was the disappearance rate of main symptoms (fever, cough, and fatigue). Results: Compared with the conventional medicine, the disappearance rate of clinical symptoms such as fever, cough, fatigue and loss of appetite in the experimental group were significantly reduced (P < 0.05). The number of white blood cells and lymphocytes in the experimental group increased significantly (P < 0.05), which all returned to normal parameters. Meanwhile, the C-reactive protein and erythrocyte sedimentation rate in the experimental group were significantly reduced (P < 0.05). Conclusion: XBD combined with conventional medicine may significantly improve patient's clinical symptoms, increase the number of white blood cells and lymphocytes to improve immunity, and also significantly reduce C-reactive protein and erythrocyte sedimentation rate to play an anti-inflammatory effect. However, it needs to be confirmed by a large sample study. Clinical trial registration: China Clinical Trial Registry (ChiCTR2000034795).

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